As oral hypoglycemic days was not used widely because
1- They are teratogenic
2- Cause hypoglycemia
3- Can not achieve optimum control of blood sugar
Now days these drug are a pragmatic alternative to insulin therapy in pregnancy because easy
administrating
Patient satisfaction as they are not invasive many study show that glyburide dose not cross the
placenta in a significant amount and :
1- It act by increase insulin secretion and dcrease insulin resistance
2- Onset of action is 4 hr and last for 10 hr
3- Starting dose 5 mg and increase gradualy up to 20 mg in 1day
4- Its success is comparable to insulin therapy treatment of un control blood sugar
5- Rote of C/s
6- Perinoted outcome
SE preecloposis , neonatal for photo therapy
Metformine : is widely used in treatment of p cos as it increase sensitivity to insulin and dcrease
insulin resistance incidence of congenital GA anomalies with it is =1.7% which is similar to
incidence of GA in general population
Action
1- Lower or dcrease peripheral uptake of glucose by the cells
2- Dcrese insulin resistance
3- Decrease hyptoz products of glucose and decrease intestine absorption of glucose
4- Should be taken within the meal to decrease GIT S.E diarrhea , gastritis ,
5- Dose 500-850 µg to 2000 µg /day , peak of action within 4 hour
6- Not cause hypoglycemia and not increase insulin secretion .